Health workers, nursing homes at front of Idaho vaccine line

Posted at 4:34 PM, Dec 05, 2020
and last updated 2020-12-05 18:34:09-05

BOISE, Idaho — Health care workers and nursing home residents will be first in line to get the coronavirus vaccine when it becomes available in Idaho in the next few weeks.

Idaho’s first batch of the vaccine arriving around Dec. 15 will likely only total about 13,650 doses, with more to follow in the subsequent weeks. That’s not nearly enough to vaccinate all of the health care workers who interact directly with COVID-19 patients or all of the long-term care facility residents who are at high risk of severe complications from the illness.

Still, the announcement from the Idaho Department of Health and Welfare represented a slim ray of hope for a state that is grappling with coronavirus infection rates so high that hospital leaders say “crisis standards of care” — when physicians must use a scoring system to determine which patients get access to life-saving medical treatment — could be enacted as soon as Christmas.

It’s not yet clear exactly how much vaccine will be sent to Idaho in the first few weeks. Dr. Carolyn Bridges, a retired CDC doctor who serves as an Idaho Department of Health and Welfare consultant, told members of Idaho’s COVID-19 Vaccine Advisory Committee in a meeting Friday that the state could get as many as 75,500 additional doses of Pfizer and Moderna vaccines by the end of the year.

Idaho has about 44,600 hospital and clinic staffers deemed essential for caring for COVID-19 patients and maintaining hospital capacity, according to Idaho Department of Health and Welfare data. The federal Centers for Disease Control and Prevention estimate the state has roughly 30,000 long-term care facility residents and staffers, though state estimates — which include in-home care providers and others — are much higher.

Regional public health districts and state leaders are struggling to figure out how to convince Idaho residents to follow basic recommendations like mask-wearing, social distancing and hand-washing in order to slow the spread of the virus. Central District Health board members met Friday to consider whether they should make mask-wearing mandatory, halt some extracurricular sports and close nursing homes to visitors in Idaho’s most populated region that includes Boise. The draft order would have made violations punishable by a misdemeanor.

But, as has become the norm in recent weeks, the meeting was interrupted by angry, shouting protesters who at times tried to force their way into the building. The board members instead voted to make some changes to the proposal and reconsider it next week. The new draft order will be released Saturday morning.

Idaho’s hospitals have been teetering on the brink of being completely overwhelmed by the pandemic in recent weeks, as widespread coronavirus transmission across the state sickened health care workers and filled hospital beds with COVID-19 patients. Idaho’s largest health care system, St. Luke’s Health System, had so many patients this week that it was, for a time, on the verge of having to divert all incoming patients elsewhere, said Dr. Jim Souza, chief medical officer.

“We will move a mountain before we go on divert,” Souza told the board. “We were this close, and what spared us is some unanticipated deaths.”

Souza said the health care system is like a swimmer who can barely keep his head above water despite treading water as fast as he can. Any additional outbreak would drown the system, he said.

Idaho’s hospital systems have already taken drastic steps to increase capacity for COVID-19 patients, postponing non-urgent surgeries, increasing the number of patients each nurse must care for, and sending some patients home earlier than they would normally be discharged.

St. Luke’s is now letting some COVID-19 patients and others leave intensive care units three or five days earlier than they otherwise might have been, sending them home with oxygen if needed, iPads so they can be in constant contact with physicians from their beds, and other equipment like oxygen level monitors that automatically send the information to hospital data centers, where it can be monitored remotely.

Souza said St. Luke’s has had about 150 patients on “remote monitoring status” for several weeks, and it is now ready to bump that number to about 300 patients at any given time.

The decision by Idaho’s COVID-19 Vaccine Advisory Committee to make the first few batches of vaccine available to health care workers and long-term care facilities is focused on increasing hospital capacity by keeping workers safe and high-risk patients protected. Long-term care facilities have become potential hotbeds of coronavirus transmission, forcing many to refuse to take COVID-19 patients who would otherwise be able to be transferred from hospital beds to care facilities.

Making the first few batches of vaccine available to both groups could help tackle the issue of overwhelmed hospitals on two fronts, state epidemiologist Dr. Christine Hahn said. The pharmaceutical companies are expected to quickly increase vaccine production and distribution once the federal review process is complete, so more doses will continue to come to the state in coming months.

“It’s going to be a very quick ramp-up, so I actually think we’ll do better the more we spread this vaccine out in the beginning,” Hahn said.

Idaho has had at least 108,366 reported coronavirus infections since the pandemic began — including more than 1,900 new cases reported Friday. At least 1,032 residents have died from COVID-19.